HAND HYGIENE AND HEALTH: AN EPIDEMIOLOGICAL STUDY OF STUDENTS IN AMRAVATI

Hands may be the most important means by which enteric pathogens are transmitted. Skin hygiene particularly of the hands, has been accepted as a primary mechanism to control the spread of infectious agents. Therefore the present study was undertaken to evaluate the number and type of enteric bacterial pathogens associated with hands. A total of 160 hands swab samples of 80 students of KG, PS, SS, UG, and PG were analyzed. Pathogens were isolated from hands includes Escherichia coli (22%), Pseudomonas aeruginosa (12%), Staphylococcus aureus (15%), Proteus mirabilis (11%), Citrobacter freundii (10%), Enterobacter aerogenes (8%), Streptococcus sp. (7%), Klebsiella sp. (6%), Micrococcus sp. (5%) and Salmonella typhi (4%). The prevalence of the bacterial pathogens was high in students of K.G. and primary than those in secondary schools and colleges. The data indicated that the hands of the female were more contaminated than male and the left hand was more contaminated than the right hand. Thus, the potential risk factors for transmission of enteric pathogens through hands should be investigated in order to improve the general health of the students

Obesity and diabetes are major risk factors for epicardial adipose tissue inflammation

BACKGROUND: Epicardial adipose tissue (EAT) directly overlies the myocardium, with changes in its morphology and volume associated with myriad cardiovascular and metabolic diseases. However, EAT’s immune structure and cellular characterization remain incompletely described. We aimed to define the immune phenotype of EAT in humans and compare such profiles across lean, obese, and diabetic patients. METHODS: We recruited 152 patients undergoing open-chest coronary artery bypass grafting (CABG), valve repair/replacement (VR) surgery, or combined CABG/VR. Patients’ clinical and biochemical data and EAT, subcutaneous adipose tissue (SAT), and preoperative blood samples were collected. Immune cell profiling was evaluated by flow cytometry and complemented by gene expression studies of immune mediators. Bulk RNA-Seq was performed in EAT across metabolic profiles to assess whole-transcriptome changes observed in lean, obese, and diabetic groups. RESULTS: Flow cytometry analysis demonstrated EAT was highly enriched in adaptive immune (T and B) cells. Although overweight/obese and diabetic patients had similar EAT cellular profiles to lean control patients, the EAT exhibited significantly (P ≤ 0.01) raised expression of immune mediators, including IL-1, IL-6, TNF-α, and IFN-γ. These changes were not observed in SAT or blood. Neither underlying coronary artery disease nor the presence of hypertension significantly altered the immune profiles observed. Bulk RNA-Seq demonstrated significant alterations in metabolic and inflammatory pathways in the EAT of overweight/obese patients compared with lean controls. CONCLUSION: Adaptive immune cells are the predominant immune cell constituent in human EAT and SAT. The presence of underlying cardiometabolic conditions, specifically obesity and diabetes, rather than cardiac disease phenotype appears to alter the inflammatory profile of EAT. Obese states markedly alter EAT metabolic and inflammatory signaling genes, underlining the impact of obesity on the EAT transcriptome profile. FUNDING: Barts Charity MGU0413, Abbott, Medical Research Council MR/T008059/1, and British Heart Foundation FS/13/49/30421 and PG/16/79/32419

System-level policies on appropriate opioid use, a multi-stakeholder consensus

Background:  This consensus statement was developed because there are concerns about the appropriate use of opioids for acute pain management, with opposing views in the literature. Consensus statement on policies for system-level interventions may help inform organisations such as management structures, government agencies and funding bodies. Methods:  We conducted a multi-stakeholder survey using a modified Delphi methodology focusing on policies, at the system level, rather than at the prescriber or patient level. We aimed to provide consensus statements for current developments and priorities for future developments. Results:  Twenty-five experts from a variety of fields with experience in acute pain management were invited to join a review panel, of whom 23 completed a modified Delphi survey of policies designed to improve the safety and quality of opioids prescribing for acute pain in the secondary care setting. Strong agreement, defined as consistent among> 75% of panellists, was observed for ten statements. Conclusions:  Using a modified Delphi study, we found agreement among a multidisciplinary panel, including patient representation, on prioritisation of policies for system-level interventions, to improve governance, pain management, patient/consumers care, safety and engagement.Publisher PDFPeer reviewe

A comprehensive curated resource for follicle stimulating hormone signaling

<p>Abstract</p> <p>Background</p> <p>Follicle stimulating hormone (FSH) is an important hormone responsible for growth, maturation and function of the human reproductive system. FSH regulates the synthesis of steroid hormones such as estrogen and progesterone, proliferation and maturation of follicles in the ovary and spermatogenesis in the testes. FSH is a glycoprotein heterodimer that binds and acts through the FSH receptor, a G-protein coupled receptor. Although online pathway repositories provide information about G-protein coupled receptor mediated signal transduction, the signaling events initiated specifically by FSH are not cataloged in any public database in a detailed fashion.</p> <p>Findings</p> <p>We performed comprehensive curation of the published literature to identify the components of FSH signaling pathway and the molecular interactions that occur upon FSH receptor activation. Our effort yielded 64 reactions comprising 35 enzyme-substrate reactions, 11 molecular association events, 11 activation events and 7 protein translocation events that occur in response to FSH receptor activation. We also cataloged 265 genes, which were differentially expressed upon FSH stimulation in normal human reproductive tissues.</p> <p>Conclusions</p> <p>We anticipate that the information provided in this resource will provide better insights into the physiological role of FSH in reproductive biology, its signaling mediators and aid in further research in this area. The curated FSH pathway data is freely available through NetPath (<url>http://www.netpath.org</url>), a pathway resource developed previously by our group.</p

Identification of sorghum genotypes with resistance to the sugarcane aphid Melanaphis sacchari under natural and artificial infestation

Sugarcane aphid, Melanaphis sacchari is an endemic pest of sorghum during postrainy season, and there is a need to develop cultivars with resistance to this pest. Evaluation of a diverse array of sorghum genotypes under natural and artificial infestation resulted in identification of seven lines (ICSB 215, ICSB 323, ICSB 724, ICSR 165, ICSV 12001, ICSV 12004 and IS 40615) with moderate levels of resistance to aphid damage. Under artificial infestation, 10 lines suffered 30 q/ha). In another experiment, ICSB 215, ICSB 695, ICSR 161, Line 61510, ICSV 12004, Parbhani Moti and IS 40618 exhibited high grain yield potential (>25 q/ha) and exhibited <50% variation in grain yield as compared to more than 80% in the susceptible check, in CK 60 B. The genotypes RSV 1211, RS 29, RSV 1338, EC 8-2, PU 10-1, IS 40617 and ICSB 695 though showed a susceptible reaction to aphid damage, but suffered relatively low loss in grain yield, suggesting that these lines have tolerance to aphid damage. Principal coordinate analysis suggested that the genotypes with aphid resistance are quite diverse and can be used to breed for aphid resistance and high grain yield potential and also in breeding for aphid resistance in sorghum with adaptation to the postrainy season

Including gaming disorder in the ICD-11: the need to do so from a clinical and public health perspective

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it

Fluid challenges in intensive care: the FENICE study A global inception cohort study

Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC.This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC.2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500-1000). The median time was 24 min (40-60 min), and the median rate of FC was 1000 [500-1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57-61 %). In 43 % (CI 41-45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34-37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20-24 %). No safety variable for the FC was used in 72 % (CI 70-74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response.The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account

Pigeonpea nutrition and its improvement

Pigeonpea (Cajanus cajan [L.] Millsp.), known by several vernacular and names such as red gram, tuar, Angola pea. yellow dhal and oil dhal, is one of the major grain legume crops of the tropics and sub-tropics. It is a crop of small holder dryland fmmers because it can grow well under subsistence level of agriculture and provides nutritive food, fodder, and fuel wood. It also improves soil by fixing atmospheric nitrogen. India by far is the largest pigeonpea producer it is consumed as decorticated split peas, popularly called as 'dhaL' In other countries, its consumption as whole dty and green vegetable is popular. Its foliage is used as fodder and milling by-products [onn an excellent feed for domestic animals. Pigeonpea seeds contain about 20-22% protein and appreciable amounts of essential amino.acids and minerals. DehuHing and boiling treatments of seeds get rid of the most antinutritional factors as tannins and enzyme inhibitors. Seed storage causes considerable losses in the quality of this legume. The seed protein of pigeonpea has been successfully enhanced by breeding from 20-22% to 28-30%. Such lines also agronomically performed well and have acceptable and color. The high-protein lines were found nutritionally superior to the cultivars because they would provide more quantities of utilizable protein and sulfur-containing amino acids